Pre-implementation planning for a sepsis intervention in a large learning health system: a qualitative study

Area of Science:

• Implementation Science
• Health Services Research
• Qualitative Research

Background:

• Sepsis survivors face significant morbidity and mortality.
• Existing best practices for post-sepsis care transition are underutilized.
• The Sepsis Transition and Recovery (STAR) program was developed to improve post-sepsis care coordination.

Purpose of the Study:

• To identify facilitators and barriers to implementing the STAR program.
• To inform pre-implementation planning for a Type I Hybrid trial.
• To understand factors influencing the successful adoption of post-sepsis care interventions.

Main Methods:

• Qualitative study using semi-structured interviews (n=16) with leaders and clinicians.
• Analysis employed a deductive/inductive strategy based on the Consolidated Framework for Implementation Research (CFIR).
• Constant Comparison Method was used for data analysis.

Main Results:

• Six facilitators identified, including alignment with health system goals and strong communication.
• Five barriers identified, such as competing staff demands and patient technology gaps.
• Facilitators and barriers spanned all five CFIR domains.

Conclusions:

• The CFIR is a robust framework for pre-implementation planning of post-sepsis care programs.
• Structured pre-implementation evaluations are crucial for designing effective interventions.
• This approach aids researchers in designing with implementation in mind before effectiveness studies.